This clinical trial studies statewide optimization of lung cancer screening (LCS) in Kentucky using the Quality Implementation of Lung Screening (QUILS™) System. Data from the Kentucky Cancer Registry shows that LCS implementation has contributed to a rapid decline in late-stage lung cancer diagnosis at twice the national average. Further, the declines are more than three times the national average decline in Kentucky's Central Appalachian region. Kentucky-based multilevel initiatives are needed to expand and accelerate this leading role and extend the LCS opportunity to more Kentuckians who are at increased risk of lung cancer. This trial may be able to accelerate optimal high-quality implementation of LCS utilizing the QUILS™ System and reduce the burden of lung cancer by assisting lung cancer screening programs located throughout Kentucky in implementing best practices in lung cancer screening by integrating the QUILS™ System domains and elements into their screening programs.

Inclusion Criteria:

• Member of a participating Lung Cancer Screening Program (LCSP) team or administrator
• Willing to participate in the QUILS Index Assessment Survey process
• Willing to participate in the QUILS Audit Feedback presentations
• Willing to participate in formative evaluation interviews

Exclusion Criteria:

• Unwilling to participate in the QUILS Index Assessment Survey process
• Unwilling to participate in the QUILS Audit Feedback presentations
• Unwilling to participate in formative evaluation interviews